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Effect of the immediately postpartum insertion of the etonogestrel releasing implant on lactation, infant growth and development


Despite the growing number of users of contraceptive methods in the last decade, the World Health Organization (WHO) estimates that 50% of pregnancies are unplanned for various reasons ranging from lack of access to contraceptives to misuse of them. Family planning measures instituted immediately postpartum period may have great impact in reversing this scenario, contributing not only to reduce unplanned pregnancies, but also to increase the intergestacional interval. The etonogestrel (ENG) releasing implant is a long acting reversible contraceptive method which is highly effective and does not require daily intervention of women to improve it effectiveness. It does not affect lactation nor the health of the newborn when inserted after four weeks of childbirth, however, there is still limited evidence that does not seem to affect these parameters when inserted immediately after delivery. Maternal health has been assessed and there seems no difference if the implant is inserted immediately after childbirth or during traditionally recommended (after 4 to 6 weeks of delivery).This study aims to assess whether there is change in the volume of milk ingested in the first six weeks by newborns whose mothers will have a ENG releasing implant inserted in the first 24 to 48 hours of delivery compared with those whose mothers will be with no contraceptive method until six weeks postpartum. Moreover, it intended to evaluate for 12 months the maternal effects (metabolic variables, bleeding pattern and satisfaction) and neonatal (development and growth) of ENG releasing implant when it is inserted immediately after the delivery versus the insertion after six weeks of the delivery. (AU)

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Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
VIEIRA, CAROLINA SALES; DE NADAI, MARIANE NUNES; DE MELO PEREIRA DO CARMO, LILIAN SHEILA; BRAGA, GIORDANA CAMPOS; INFANTE, BRUNA FREGONESI; STIFANI, BIANCA M.; FERRIANI, RUI ALBERTO; QUINTANA, SILVANA MARIA. Timing of postpartum etonogestrel-releasing implant insertion and bleeding patterns, weight change, 12-month continuation and satisfaction rates: a randomized controlled trial. Contraception, v. 100, n. 4, p. 258-263, . (13/00795-3)
DE MELO PEREIRA CARMO, LILIAN SHEILA; BRAGA, GIORDANA CAMPOS; FERRIANI, RUI ALBERTO; QUINTANA, SILVANA MARIA; VIEIRA, CAROLINA SALES. Timing of Etonogestrel-Releasing Implants and Growth of Breastfed Infants A Randomized Controlled Trial. OBSTETRICS AND GYNECOLOGY, v. 130, n. 1, p. 100-107, . (13/00795-3)

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